NC budget breakthrough has over $200 million for Duke-UNC children’s hospital
AI-generated summary reviewed by our newsroom.
- Republican leaders reached a deal to provide $208 million toward NC Children’s funding.
- Lawmakers plan to begin writing a final budget bill after resolving hospital funding.
- Duke and UNC previously estimated the Apex hospital would cost about $3 billion.
Republican legislative leaders announced Tuesday they had reached a deal to move forward on North Carolina’s long-delayed budget, including an agreement to provide $208 million for a proposed children’s hospital being built by Duke Health and UNC Health.
Senate leader Phil Berger told reporters during a news conference with House Speaker Destin Hall announcing the deal that a total of $208 million would be dedicated to NC Children’s, the planned pediatric hospital network led by Duke Health and UNC Health.
Additionally, there’s “an understanding that we’ll continue to discuss whether or not any additional dollars” will be provided, Berger said.
The leaders said that now that an agreement has been reached on various budget sticking points, including the hospital funding, they can begin writing a final budget bill, which they do not expect before June.
North Carolina’s budget was due last June. But since the House and Senate failed to strike a deal, they have been operating at funding levels laid out in the 2023 budget.
The 2023 deal
In 2023, lawmakers in the GOP-led legislature agreed to spend $320 million on NC Children’s. They also agreed to spend about $420 million on what’s dubbed the NC Care Initiative, a rural health program run by ECU Health, UNC Health and their medical school partners. That initiative included the establishment of three new rural clinics.
Sen. Michael Lee, a Republican budget writer, told The News & Observer last September when budget talks were falling through that the Senate was not seeking new money and wanted the House to honor the 2023 agreement that uses federal American Rescue Plan Act funds received for Medicaid expansion to fund both health initiatives.
Records obtained at the time by The N&O showed the 2023 ARPA agreement mapped out spending through 2026. For the current fiscal year ending in June, the plan called for $103.5 million for NC Children’s and $105 million for NC Care. NC Children’s previously received over $216 million.
Berger told reporters after a Senate session Tuesday that the $208 million comes from remaining funds that still needed to be paid out for the hospital, as well as money previously set aside for the NC Care Initiative.
Hall, who was not the speaker in 2023, last year expressed doubts about the need to release that funding for the hospital project.
Asked Tuesday by The N&O about reaching a hospital funding deal, Hall said, “We’ve met with those folks a lot, tried to learn more about the project, and so it’s sort of an ongoing discussion about how to handle that particular project.”
Beyond the $208 million, Hall said, “We’ll see if part of our deal ends up being some more funding for it. It’s a big project. It’s a lot of moving parts.
“We certainly don’t oppose a children’s hospital being in the state. We’ve got a few of them already. We don’t oppose another one,” he added.
But Hall said a concern he has had is that “if we’re going to give that kind of funding to a hospital in Apex, we need to think about the rural hospitals in particular, making sure they’re getting the capital they need,” specifically pointing to Martin County.
Martin General Hospital shut down in August 2023. In May 2025, ECU Health announced a plan to acquire and repurpose the facility. According to reporting from NC Health News last month, ECU Health is currently seeking a $220 million appropriation from state legislators to fund the project.
Duke and UNC previously estimated the Apex-based hospital will cost approximately $3 billion and that construction should begin in 2027, taking six years to complete.
The N&O requested comment from both health systems. UNC Health spokesperson Alan Wolf said on behalf of NC Children’s that “we are grateful to our state leaders for their continued support of North Carolina Children’s and our shared goal of creating a brighter, healthier future for our children.
“We continue to make progress toward opening the state’s first independent, dedicated children’s hospital and remain on track to break ground in late 2027,” he wrote.
This story was originally published May 13, 2026 at 9:31 AM.
